Lpidoforos E, Oteriades SS, Ane J, et al. Incidence and prognosis of syncope. N Engl J Med. 2009;347:878–85. https://doi.org/10.1056/NEJMOA012407.

Article  Google Scholar 

Brignole M, Moya A, De Lange FJ, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39(21):1883–948. https://doi.org/10.1093/EURHEARTJ/EHY037.

Article  PubMed  Google Scholar 

Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American college of cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society. Circulation. 2017;136(5):e60–122. https://doi.org/10.1161/CIR.0000000000000499.

Article  PubMed  Google Scholar 

Shields RW. Functional anatomy of the autonomic nervous system. J Clin Neurophysiol. 1993;10(1):2–13. https://doi.org/10.1097/00004691-199301000-00002.

Article  PubMed  Google Scholar 

Goldberger JJ, Arora R, Buckley U, Shivkumar K. Autonomic nervous system dysfunction: JACC focus seminar. J Am Coll Cardiol. 2019;73(10):1189–206. https://doi.org/10.1016/j.jacc.2018.12.064.

Article  PubMed  PubMed Central  Google Scholar 

Westfall TC. Local regulation of adrenergic neurotransmission. Physiol Rev. 1977;57(4):659–728. https://doi.org/10.1152/PHYSREV.1977.57.4.659.

Article  CAS  PubMed  Google Scholar 

Smolen AJ. Morphology of synapses in the autonomic nervous system. J Electron Microsc Tech. 1988;10(2):187–204. https://doi.org/10.1002/JEMT.1060100205.

Article  CAS  PubMed  Google Scholar 

Ito M, Zipes DP. Efferent sympathetic and vagal innervation of the canine right ventricle. Circulation. 1994;90(3):1459–68. https://doi.org/10.1161/01.CIR.90.3.1459.

Article  CAS  PubMed  Google Scholar 

Crick SJ, Anderson RH, Ho SY, Sheppard MN. Localisation and quantitation of autonomic innervation in the porcine heart II: endocardium, myocardium and epicardium. J Anat. 1999;195(3):359–73. https://doi.org/10.1046/J.1469-7580.1999.19530359.X.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Aksu T, Yalin K, Mutluer FO, et al. The impact of the clinical diagnosis on the vagal response and heart rate after ganglionated plexus ablation. J Interv Card Electrophysiol Published online. 2022. https://doi.org/10.1007/S10840-022-01270-5.

Article  Google Scholar 

Sra JS, Jazayeri MR, Avitall B, et al. Comparison of cardiac pacing with drug therapy in the treatment of neurocardiogenic (vasovagal) syncope with bradycardia or asystole. N Engl J Med. 1993;328(15):1085–90. https://doi.org/10.1056/NEJM199304153281504/ASSET/19E59A49-F425-40B1-A551-36BAF035A9DE/ASSETS/IMAGES/LARGE/NEJM199304153281504_F4.JPG.

Article  CAS  PubMed  Google Scholar 

Romme JJCM, Reitsma JB, Black CN, et al. 2011 Drugs and pacemakers for vasovagal, carotid sinus and situational syncope. Cochrane Database Syst Rev 2011(10). https://doi.org/10.1002/14651858.CD004194.PUB3/INFORMATION/EN

Sridharan A, Bradfield JS, Shivkumar K, Ajijola OA. Autonomic nervous system and arrhythmias in structural heart disease. Auton Neurosci. 2022;243. https://doi.org/10.1016/J.AUTNEU.2022.103037.

Calvillo L, Vanoli E, Andreoli E, et al. Vagal stimulation, through its nicotinic action, limits infarct size and the inflammatory response to myocardial ischemia and reperfusion. J Cardiovasc Pharmacol. 2011;58:500–7.

Article  CAS  PubMed  Google Scholar 

Pachon MJC, Pachon MEI, Cunha Pachon MZ, Lobo TJ, Pachon MJC, Santillana PTG. Catheter ablation of severe neurally meditated reflex (neurocardiogenic or vasovagal) syncope: cardioneuroablation long-term results. EP Europace. 2011;13(9):1231–42. https://doi.org/10.1093/EUROPACE/EUR163.

Article  Google Scholar 

Pachon-M EI, Pachon-Mateos JC, Higuti C, et al. Relation of fractionated atrial potentials with the vagal innervation evaluated by extracardiac vagal stimulation during cardioneuroablation. Circ Arrhythm Electrophysiol. 2020;13:302–13. https://doi.org/10.1161/CIRCEP.119.007900.

Article  Google Scholar 

Aksu T, Golcuk E, Yalin K, Guler TE, Erden I. Simplified cardioneuroablation in the treatment of reflex syncope, functional AV block, and sinus node dysfunction. Pacing Clin Electrophysiol. 2016;39(1):42–53. https://doi.org/10.1111/PACE.12756.

Article  PubMed  Google Scholar 

Aksu T, Padmanabhan D, Shenthar J, et al. The benefit of cardioneuroablation to reduce syncope recurrence in vasovagal syncope patients: a case-control study. J Interv Card Electrophysiol. 2022;63(1):77–86. https://doi.org/10.1007/S10840-020-00938-0/FIGURES/5.

Article  PubMed  Google Scholar 

Aksu T, Guler TE, Bozyel S, Yalin K. Selective vagal innervation principles of ganglionated plexi: step-by-step cardioneuroablation in a patient with vasovagal syncope. J Interv Card Electrophysiol. 2021;60(3):453–8. https://doi.org/10.1007/S10840-020-00757-3/FIGURES/1.

Article  PubMed  Google Scholar 

Aksu T, Gopinathannair R, Bozyel S, Yalin K, Gupta D. Cardioneuroablation for treatment of atrioventricular block. Circ Arrhythm Electrophysiol. 2021;14:841–50. https://doi.org/10.1161/CIRCEP.121.010018.

Article  CAS  Google Scholar 

Linz D, Stavrakis S. Cardioneuroablation for vasovagal syncope: how to move beyond “learning by burning”? Journal of Interventional Cardiac Electrophysiology. Published online April 29, 2022:1–3. https://doi.org/10.1007/S10840-022-01232-X/FIGURES/1.

Aksu T, Gopinathannair R, Gupta D, Pauza DH. Intrinsic cardiac autonomic nervous system: what do clinical electrophysiologists need to know about the “heart brain”? J Cardiovasc Electrophysiol. 2021;32(6):1737–47. https://doi.org/10.1111/JCE.15058.

Article  PubMed  Google Scholar 

Armour JA. Potential clinical relevance of the “little brain” on the mammalian heart. Exp Physiol. 2008;93(2):165–76. https://doi.org/10.1113/EXPPHYSIOL.2007.041178.

Article  CAS  PubMed  Google Scholar 

Fedele L, Brand T. The intrinsic cardiac nervous system and its role in cardiac pacemaking and conduction. J Cardiovasc Dev Dis. 2020;7(4):1–33. https://doi.org/10.3390/JCDD7040054.

Article  Google Scholar 

Fernholm M. On the development of the sympathetic chain and the adrenal medulla in the mouse. Z Anat Entwickl. 1971;133(3):305–17. https://doi.org/10.1007/bf00519305.

Article  CAS  Google Scholar 

Becker RF, Grunt JA. The cervical sympathetic ganglia. Anat Rec. 1957;127(1):1–14. https://doi.org/10.1002/ar.1091270102.

Article  CAS  PubMed  Google Scholar 

Kawashima T. The autonomic nervous system of the human heart with special reference to its origin, course, and peripheral distribution. Anat Embryol (Berl). 2005;209(6):425–38. https://doi.org/10.1007/S00429-005-0462-1/METRICS.

Article  PubMed  Google Scholar 

Ellison JP, Williams TH. Sympathetic nerve pathways to the human heart, and their variations. Am J Anat. 1962;124(2):149–62. https://doi.org/10.1002/aja.1001240203.

Article  Google Scholar 

Levy MN. Sympathetic-parasympathetic interactions in the heart. Circ Res. 1971;29(5):437–45. https://doi.org/10.1161/01.RES.29.5.437.

Article  CAS  PubMed  Google Scholar 

Levy MN, Zieske H. Autonomic control of cardiac pacemaker activity and atrioventricular transmission. J Appl Physiol. 1969;27(4):465–70. https://doi.org/10.1152/JAPPL.1969.27.4.465.

Article  CAS  PubMed  Google Scholar 

Lee S, Wellens HJJ, Josephson ME. Paroxysmal atrioventricular block. Heart Rhythm. 2009;6(8):1229–34. https://doi.org/10.1016/j.hrthm.2009.04.001.

Article  PubMed  Google Scholar 

Guo YP, Mcleod JG, Baverstock J. Pathological changes in the vagus nerve in diabetes and chronic alcoholism. J Neurol Neurosurg Psychiatry. 1987;50(11):1449–53. https://doi.org/10.1136/JNNP.50.11.1449.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chen PS, Chen LS, Fishbein MC, Lin SF, Nattel S. Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy. Circ Res. 2014;114(9):1500–15. https://doi.org/10.1161/CIRCRESAHA.114.303772.